Integrated Assessment Tool

KEEP THE PRESSURE ON - ACT NOW to help our ageing population

As health practitioners, we recognize the prevalence of chronic oedema among the elderly. The Integrated Assessment Tool (IAT) is currently under development due to the Royal Commission into Aged Care Quality and Safety. Scheduled for implementation in July 2024, the IAT aims to streamline assessment processes for Commonwealth-subsidised aged care services, consolidating ACAT, RAS, and AN-ACC assessors into a unified system. However, chronic oedema screening is notably absent from the current framework.

It is crucial that we advocate for its inclusion in the IAT to ensure our elderly population’s needs are met. We must collectively lobby our federal ministers, urging them to address this gap. By explaining the importance of including chronic oedema screening and providing clear guidance on implementation, we can ensure our voices are heard. Attached is a template outlining the rationale for inclusion and a simple screening method, such as the 10-second pitting test, which has been supported by research findings. I know as part of the lymphoedema practitioner’s assessment, the pitting test is much longer, but remember, we aren’t asking them to diagnose or assess the type of oedema but rather observe if there is the presence of oedema.

Please do the following today

Let's work together to advocate for the health and well-being of older Australians.

1. Find your local member

2. Copy the text below and email it to your local member

Subject for your email:  Including Chronic Oedema Screening in the Integrated Assessment Tool (IAT)

Dear [INSERT NAME],

I am writing to seek your support for the health of our ageing population by advocating for the inclusion of chronic oedema screening in the Integrated Assessment Tool.

The Integrated Assessment Tool will assess all aged care services. From July 2024, this new assessment tool will be used to assess the eligibility of older people in Australia for Commonwealth-subsidised aged care services and aged care programs. It will provide a single assessment pathway and brings together ACAT, RAS and AN-ACC assessors into a single system.

Chronic oedema in the lower limbs in the ageing population is a common problem. An audit conducted by a community aged care provider in Sydney between 2020 and 2022 of their home care clients, involving 459 clients, revealed that 38% of them exhibited leg oedema. This aligns with international data.

There are many causes of chronic oedema, and it could indicate serious health problems such as heart failure.  Untreated chronic oedema can severely affect health and quality of life, causing reduced mobility and increased falls risk, increase chance of leg ulcers, pressure injuries and cellulitis (skin infection that left untreated can lead to sepsis). The psychological toll of coping with chronic swelling can negatively impact mental health.

Chronic Oedema must be included in the IAT

Screening chronic oedema as part of the IAT will lead to early intervention and long-term health cost savings. It is quick and easy and doesn’t require the assessor to be a health professional. The IAT assessor should:

  • Ask the person if they have a history of swelling in their feet and ankles.
  • Observe the feet and ankles for the presence of oedema.
  • Perform a 10 second pitting test which involves pressing the thumb on the top of the foot, and behind the ankle bones on both feet. Observe if there is a dent created.
  • If a dent is created, a referral to a health professional is instigated for further assessment and management.

At a minimum, the IAT assessor should

  • Ask the person if they have a history of swelling in their feet and ankles.
  • Observe the feet and ankles for the presence of oedema.
  • If the person indicates they have a history of swelling and or the assessor observes oedema in the feet and ankles, a referral to a health professional is instigated for further assessment and management.

I ask you to support the health of our aging population by writing to Hon Anika Wells, Minister for Aged Care and requesting that chronic oedema screening be included in the Integrated Assessment Tool.

Yours faithfully,

[YOUR NAME

[Your electoral address – required for the member to confirm you are a constituent]

3. Ask family, friends, and patients to do the same

We are running out of time so let’s make this our campaign during lymphoedema awareness month. WE CAN MAKE A HUGE DIFFERENCE. It will only succeed if we have the power of numbers, and it will only take you a few moments.

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